J7509 HCPCS code: Methylprednisolone oral, per 4 mg
J7509 is the HCPCS Level II code for methylprednisolone oral, per 4 mg. In 2024 Medicare paid an average of $0.18 per service for J7509 across 19,697 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 360 per day on DME suppliers. Medicare volume fell 26% from 2022 to 2024 (26,692 to 19,697 services). In 2024, 87 suppliers billed Medicare for J7509 (purchases), serving 98 beneficiaries; Florida, New York, California accounted for 72% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 1996-01-01 |
| Last action effective | 2000-01-01 |
Who bills J7509 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 87 |
| Referring clinicians | 107 |
| Medicare beneficiaries | 98 |
| States with claims | 10 |
| Share of services in top 3 states (Florida, New York, California) | 72% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 92 | 108 |
| 2023 | 95 | 105 |
| 2024 | 87 | 98 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J7509, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 26,692 | 108 | $0.27 | $0.20 |
| 2023 | 21,200 | 105 | $0.26 | $0.19 |
| 2024 | 19,697 | 98 | $0.24 | $0.18 |
States with the most J7509 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 6,133 | $0.18 |
| New York | 4,685 | $0.17 |
| California | 2,411 | $0.19 |
| Connecticut | 1,067 | $0.19 |
| Pennsylvania | 1,020 | $0.17 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 360 | Clinical: Data |
| outpatient hospital claims | 60 | Prescribing Information |
What changed for J7509
- 1996-01-01: J7509 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J7509?
J7509 is the HCPCS Level II code for methylprednisolone oral, per 4 mg. Short descriptor: "Methylprednisolone oral".
How much does Medicare pay for J7509?
In 2024, the average Medicare payment was $0.18 per service (average allowed $0.24).
Does Medicare cover J7509?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J7509 can be billed per day?
360 on DME suppliers; 60 on outpatient hospital claims (NCCI medically unlikely edits).
Related J75 codes
- J7500 — Azathioprine, oral, 50 mg
- J7501 — Azathioprine, parenteral, 100 mg
- J7502 — Cyclosporine, oral, 100 mg
- J7503 — Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg
- J7504 — Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg
- J7505 — Muromonab-cd3, parenteral, 5 mg
- J7506 — Prednisone, oral, per 5 mg
- J7507 — Tacrolimus, immediate release, oral, 1 mg
- J7508 — Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg
- J7510 — Prednisolone oral, per 5 mg
- J7511 — Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg
- J7512 — Prednisone, immediate release or delayed release, oral, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J7509
- Watch J7509 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7509
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.